Abstract
Background: The aim was to study the effect of metformin in a lifestyle modification program combined with oral contraceptive pills on quality of life parameters measured by PCOS questionnaire in women and validate PCOSQ.
Methodology: Total 50 willing patients with PCOS participated in this hospital based single centered pilot study. Patients had to rate the symptoms given in questionnaire concerning health and health related issues on a scale of 1-7. Random selection for treatment with OC pills with or without Metformin was made. Post treatment analysis of their quality of life was done with the same questionnaire and data was analyzed by SPSS statistical software.
Result: The patients taking metformin along with OC Pills showed significant improvement in menstrual irregularities, hirsutism and the psychological distress related to it. Neither the symptoms related to being overweight was improved significantly nor the Psychological and emotional conditions regarding the symptoms. Similar results were obtained when we compared pre and post therapy scores in patients taking placebo in place of metformin.
Conclusion: This study validated the PCOS questionnaire in Indian population which can be considered first of its kind. This can give us an objective method of response assessment in patients with PCOS and also showed no significant additional effect of metformin on improvement of symptoms in patients with PCOS, which could be secondary to either small sample size or short duration of action.
Keywords: Metformin, PCOS, hirsutism, acne, HRQL, Health-related quality of life, Overweight.
References
- Azziz R, Marin C, et al. Health care-related economic burden of the polycystic ovary syndrome during the reproductive life span. J Clin Endocrinol Metab 2005;90:4650-8.
- Nidhi R, Padmalatha V, et al Prevalence of polycystic ovarian syndrome in Indian adolescents. J Pediatr Adolesc Gynecol 2011;24:223-7.
- Trent M, Rich M, et al Quality of life in adolescent girls with polycystic ovary syndrome. AMA. 2002; 156(6):556–560.
- Pekhlivanov B, Kolarov G, et al Determininants of health related quality of life in women with polycystic ovary syndrome. Akusherstvo I Ginkekologiia. 2006; 45(7):29–34.
- Yen SSC. The polycystic ovary syndrome. Clin Endocrinol (Oxf.) 1980;12:177–208.
- Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group: Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004; 81:19 –25.
- Asuncion M, Calvo RM, San Millan JL, Sancho J, Avila S, Escobar-Morreale HF. A prospective study of the prevalence of the polycystic ovary syndrome in unselected Caucasian women from Spain. J Clin Endocrinol Metab. 2000;85:2434–
- Guyatt G, Weaver B, Cronin L, Dooley JA, Azziz R. Health-related quality of life in women with polycystic ovary syndr-ome, a self-administered questionnaire, was validated. J Clin Epidemiol. 2004;57:1279–
- Barnard L, Ferriday D, Guenther N, Strauss B, Balen AH, Dye L. Quality of life and psychological well being in polycystic ovary syndrome. Hum Reprod. 2007;22:2279–
- Elsenbruch S, Hahn S, Kowalsky D, Öffner AH, Schedlowski M, Mann K, Janssen OE. Quality of life, psychosocial well-being, and sexual satisfaction in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2003; 88:5801–
- Elsenbruch S, Benson S, Hahn S, Tan S, Mann K, Pleger K, Kimmig R, Janssen OE. Determinants of emotional distress in women with polycystic ovary syndrome. Hum Reprod. 2006;21:1092–
- Lipton MG, Sherr L, Elford J, Rustin MHA, Clayton WJ. Women living with facial hair: the psychological and behavioral burden. J Psychosom Res. 2006;61:161–
- Coffey S, Bano G, Mason HD. Health-related quality of life in women with polycystic ovary syndrome: a comparison with the general population using the Polycystic Ovary Syndrome Questionnaire (PCOSQ) and the Short Form- 36 (SF-36). Gynecol Endocrinol. 2006;22:80–
- Schmid J, Kirchengast S, Vytiska-Binstorfer E, Huber J. Infertility caused by PCOS–health-related quality of life among Austrian and Moslem immigrant women in Austria. Hum Reprod. 2004;19:2251–
- Zhao Y, Qiao J. Ethnic differences in the phenotypic expression of polycystic ovary syndrome. Steroids. 2013;78:755–
- Ou H-t, Wu M-H, Lin C-Y, Chen P-C. Development of Chinese Version of Polycystic Ovary Syndrome Health-Related Quality of Life Questionnaire (Chi-PCOSQ). PLoS One. 2015;10:e0137772.
- Sivalingam VN, Myers J, Nicholas S, Balen AH, Crosbie EJ. Metformin in reproductive health, pregnancy and gynaecological cancer: established and emerging indications. Hum Reprod Update. 2014;20:853–
- Nestler JE. Metformin for the treatment of the polycystic ovary syndrome. N Engl J Med. 2008;358:47–
- Genazzani AD, Ricchieri F, Prati A, Chierchia E, Rattighieri E, Bosco G, Despini G, Campedelli A, Farinetti A, Santagni S. PCOS and metformin: from pharmacology to clinical use for women’s health. Trial. 2012;12:14.
- Ou H-t, Chen P-C, Wu M-H: Effect of metformin by employing 2-hour postload insulin for measuring insulin resistance in Taiwanese women with polycystic ovary syndrome. Journal of the Formosan Medical Association 2016.
- Tang T, Glanville J, Hayden CJ, White D, Barth JH, Balen AH. Combined lifestyle modification and metformin in obese patients with polycystic ovary syndrome. A randomized, placebo
- Trent ME, Rich M, Austin BS, Gordon CM. Fertility concerns and sexual behavior in adolescent girls with polycystic ovary syndrome implications for quality of life. J Ped and Adolesc Gyn 2003;16(1):33–7.
- Hillard PJ Oral contraceptives and the management of hyperandrogenism-polycystic ovary syndrome in adolescents. Endocrinol Metab Clin North Am 2005; 34:707–723
- Huber-Buchholz MM, Carey DG, et al Restoration of reproductive potential by lifestyle modification in obese polycystic ovary syndrome: role of insulin sensitivity and luteinizing hormone. J Clin Endocrinol Metab 1999; 84:1470–1474.
- Hahn S, Benson S, Elsenbruch S, Pleger K, Tan S, Mann K, et al. Metformin treatment of polycystic ovary syndrome improves health-related quality of life, emotional distress and sexuality. Hum Reprod. 2006; 10:1093.
- Cronin et al. Development of a health-related quality-of-life questionnaire (PCOSQ) for women with polycystic ovary syndrome (PCOS).J Clin Endo & Met 1998;83(6):1976– 87.
- Miranda Harris-Glocker,. Kristin Davidson, et al. Improvement in quality-of-life questionnaire measures in obese adolescent females with polycystic ovary syndrome treated with lifestyle changes and oral contraceptives, with or without metformin Fertil Steril; 2010; 93:1016-13.
- Ou HT, Chen PC, Wu MH, Lin CY. Metformin improved health-related quality of life in ethnic Chinese women with polycystic ovary syndrome. Health and quality of life outcomes. 2016 Aug 24;14(1):119.
Corresponding Author
Dr Basanta Kumar Pati
Associate Professor, Department of Obstetrics and Gynaecology,
IMS & SUM Hospital, Bhubaneswar, ''
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v5i12.84
